Provider Demographics
NPI:1336544584
Name:WP MALONE INC
Entity Type:Organization
Organization Name:WP MALONE INC
Other - Org Name:ALLCARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYCOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-210-9209
Mailing Address - Street 1:PO BOX 524
Mailing Address - Street 2:
Mailing Address - City:ARKADELPHIA
Mailing Address - State:AR
Mailing Address - Zip Code:71923-0524
Mailing Address - Country:US
Mailing Address - Phone:870-246-5553
Mailing Address - Fax:870-245-1790
Practice Address - Street 1:1903 GRANT AVE STE IANDJ
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-6134
Practice Address - Country:US
Practice Address - Phone:870-935-6364
Practice Address - Fax:870-245-1790
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:W P MALONE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-30
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR182573336C0003X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR124729407Medicaid
AR0418257OtherNCPDP